VAAC Report December 2019

DECEMBER 4, 2019

REPORT TO THE ADVISORY COMMITTEE

Air Force Capt. Andrew “Dojo” Olson, commander of the F-35 Demonstration Team, performs a high-speed pass during the Oregon International Airshow in McMinnville, Ore., Sept. 21, 2019.

Photo by Air Force Senior Airman Alexander Cook

ADVISORY COMMITTEE December 4, 2019 ADVISORY COMMITTEE John Howard, USN, Chair ............................................................................... Medford Reyn Leno, USMC, Vice Chair .................................................................. Grand Ronde Christine Gittins, USA, Secretary ................................................................... Redmond Dennis Guthrie, USA .................................................................................... Redmond Adolph “Val” Valfre, Jr., USAF…………………………..........................................Forest Grove Rosy Macias, USMC ............................................................................................Salem James Gardner, USA ........................................................................................Eugene Robert “Bob” Van Voorhis, USA .................................................................... John Day Nell Stamper, USCG………………………………………………………………………………………...Astoria ODVA STAFF Kelly Fitzpatrick ............................................................................................. Director Martha-Estela Garcia ................................................. Special Assistant to the Director ........................................................................................................... Deputy Director Joseph Bell……………………………………………….Executive Assistant to the Deputy Director Jennifer Donovan ........................................................................Senior Policy Advisor Bruce Shriver ............................................................................. Chief Financial Officer Sheronne Blasi .................................................... Director, Statewide Veteran Services Ana Potter ................................................................. Director, Aging Veteran Services Kelly Breshears.…………………………………….…… Assistant Director, Aging Veteran Services Nicole Hoeft ....................................................................... Director, Communications Cody Cox ...................................................... Veteran’s Home Loan Program Manager John Osborn ........................................................ Facilities and Construction Manager Julie Owens ...................................................................... Human Resources Manager John Haytas .................................................................. Information Services Manager

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ADVISORY COMMITTEE

Quarterly Meeting Agenda Wednesday, December 4, 2019 | 9:30 AM – 12:00 PM Department of Public Safety Standards and Training | 4190 Aumsville Hwy SE, Salem, OR 97317 I. WELCOME AND ADMINISTRATION – Business Meeting • Call to Order – Chair John Howard • Pledge of Allegiance – Chair John Howard • Moment of Silence – Chair John Howard • Swearing in of New Officers – Chair Howard & Director Fitzpatrick • Committee Member Introductions • Meeting Rules – Vice Chair Reyn Leno • Audience Introductions • Review and Approval of September 11, 2019 Minutes II. ODVA DIRECTOR’S REPORT – ODVA Director, Kelly Fitzpatrick III. Reports and Presentations • VA Mission Act Update: Darwin Goodspeed, Director Portland VA Health Care System • Blue Water Navy Veterans: Michael Rohrbach, Asst Director VA Portland Regional Office • Veterans Housing Presentation: Gus Bedwell, OHCS Veterans Housing Integrator • Veterans Behavioral Health Study: Emily Watson, OHA Veterans Behavioral Health Liaison • Reporting Veteran Suicide in Oregon’s Counties:  A View from Grand Ronde: Reyn Leno ODVA Advisory Committee Member **********************************BREAK************************************* IV. OLD BUSINESS ITEMS • Open for Committee Members V. NEW BUSINESS • Open for Committee Members • Next Advisory Committee Quarterly Meeting: Date: Wednesday, March 4, 2020| Time: 9:30 AM – 12:00 PM Location: Tillamook Bay Community College | 4301 Third St, Tillamook OR 97141

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VII. PUBLIC COMMENT (Speakers Limited to 3 Minutes) Public comment time is set aside for persons wishing to address the Advisory Committee on agenda matters. Action will not be taken at this meeting on citizen comments. However, the Advisory Committee, after hearing from interested citizens, may place items on a future agenda so proper notice may be given to all interested parties. At the conclusion of the meeting, there will be a Town Hall forum for individuals to bring up broader veteran community issues.

Members of the community may also submit written public comments to the Committee at the following email address: vaac@odva.state.or.us VIII. BUSINESS MEETING ADJOURNED OPEN FORUM CONNECT WITH ODVA WEBSITE www.oregon.gov/odva BLOG www.oregondva.com FACEBOOK www.facebook.com/odvavet TWITTER @oregondva or www.twitter.com/OregonDVA ADVISORY COMMITTEE vaac@odva.state.or.us PUBLIC INFORMATION ODVAinformation@odva.state.or.us SUBMIT AN EVENT www.oregon.gov/odva/Connect/Pages/Events.aspx SUBMIT A STORY VetsNews@odva.state.or.us EMAIL SUBSCRIBE & Vets News www.oregon.gov/odva (Under “Connect with ODVA then Agency Publications”) LEGISLATIVE Page www.oregon.gov/odva/Connect/Pages/Legislation.aspx

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The Following Pages include the September 11, 2019 Meeting Minutes for Advisory Committee Approval

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ADVISORY COMMITTEE

Quarterly Meeting Agenda Wednesday, September 11, 2019 | 9:30 AM – 12:00 PM Holiday Inn Express | 34 N. Holladay Dr., Seaside OR 97138 Chair John Howard called the meeting to order at 9:30 AM. Pledge of Allegiance was recited.

Moment of Silence was observed for service members who have passed away and all that are still serving.

Committee Members Present - Introductions: John Howard – Medford, US Navy, former legislative assistant to Congressman Walden Dennis Guthrie – Redmond, US Army Val Valfre – Forest Grove, US Air Force Bob Van Voorhis – John Day, US Army Nell Stamper – Astoria, US Coast Guard Committee Members Absent: Christine Gittins – Redmond, US Army Reyn Leno – Grande Ronde, US Marine Corps James Gardner – Eugene, US Army Rosy Macías – Salem, US Marine Corps Meeting Rules: John Howard, Chair, reviewed the rules of Advisory Committee public meetings for those in attendance.

Audience Introductions: Shannon Compton – US Army, Transition Assistance Advisor Jay Little – US Marine Corps, Meloni Beauchamp – US Army, Military One Source Jim Ordway – US Army Kim Wright – US Army Diane Guthrie – US Army Spouse Luke Thomas – Clatsop County VSO Review and Approval of September 11, 2019 Meeting Minutes: A motion was made by Dennis Guthrie to accept the minutes and seconded by Bob Van Voorhis.

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Director’s Report – ODVA Director, Kelly Fitzpatrick Director Fitzpatrick presented the Director’s Report.

She shared the following highlights with the committee: • Thanked everyone for their service, especially on the day of National Day of Service • Reviewed some of the 2019 bills in the report from ODVA’s Senior Policy Advisor  SB 35, SB 36, SB 37 are ODVA housekeeping bills, change make current the wording in statue, make permanent Campus Veteran Grant Program ($1 Million for this program)  SB 5538, ODVA’s budget bill  SB 5543 ODVA Budget increase for State Approving Authority with 1 October 2019 being the formal stand up of the SAA and with Kim Douthit being hired to manage that section  HB 2201 Bridge Grant for Veterans Receiving GI Bill benefits sponsored by Representative Evans - $300,000 for grants  HB 2202 Bureau of Labor and Industries to inform veterans about apprenticeship programs  HB 2462 Courts must notify veteran defendant that may be eligible for diversion or treatment programs (counties have been understaffed and in turn not able to stand up a Veterans Treatment Court) • Lottery Funds continue to play a positive role • Veterans Behavioral Health Report was funded by lottery funds through an Oregon Health Authority  Report being publicized  Veterans, Family members, and Providers are invited to forums about the report Question by Jay Lillie, audience member: The amount of money that goes to the organizations receiving lottery funds, do you get to say how much or where or does it come from the legislature?

Answer from Director: The amount of money that goes to the other agencies is determined by the legislature with input from the veteran’s committees.

Question by Dennis Guthrie, committee member: on HB 2195, Vietnam Veterans War Memorial, why did it not pass? What needs to be done to get it passed?

Answer from Director: Steve Bates, the Vietnam Veterans War Memorial Chair, shared that the reason the bill did not pass was that a Task Force needed to be set up and one had not been set up yet. He continues to work with legislatures on the bill to get the land from Parks and Recreation.

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Question from Val Valfre, committee member: Why was HB 2203 not approved?

Answer from the Director: At the end of the session, there were a lot of bills that were still active and did not make it and this seems to be one of them.

Question from John Howard, committee member: Will the Veterans Services Grant be continued?

Answer from the Director: Yes, it will, bumped up to $1 million.

• • • • •

Director Fitzpatrick shared that ODVA is preparing to make an offer to person to become the Grant Coordinator for all the grants from ODVA $200,000 going out to Tribal Veterans Officers ODVA to hire a Tribal Veterans Coordinator Special Project: $5 million towards YMCA affordable housing project for veterans Additional Rep Payee Position added to ODVA’s Aging Veterans Services Department

Question from Luke Thomas, CVSO: On the bills that did not pass, SB 500A, will it be readdressed?

Answer from the Director: Senator Olsen has been working this bill for several years and this is the closest that it has made it and will most likely be representing it.

Comment from Luke Thomas: “I have veterans contact me all the time that they are leaving the state and when I ask why the response is always the same. Taxes. There are other states with better benefits for veterans.”

Director Fitzpatrick encourages individuals if they have concerns about taxes to contact their state representatives and let them know. The feedback helps by letting the legislatures know and hear from the veterans and their perspective.

Question from Jay Lillie: Will the dead bills be able to be brought back in the short session?

Answer from the Director: Every legislature has a limited quota that they can put forward and the governor has around 5, so they will be very picky about which bills get put forward. It is more likely to see them come back in the 20-21 long session.

Question from Jay Lillie: Did general funding for ODVA come about the way you thought it would or did it suffer from the fact that lottery funds were ok? Did it meet your ability to fund what you needed to?

Answer from the Director: Absolutely, ODVA is pleased with the level of both the general funds and lottery funds received. General funds have remained pretty stable with a tiny uptick in funding.

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ODVA Veterans Expo re-cap – held in Pendleton, OR  Town Hall held the night before; question asked about working on nuclear rounds and health complications from veteran lead to great conversation and a representative from the National Association from Atom Veterans raised his hand to assist this veteran further  Close to 300 veterans attended, great for a rural area

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Veterans Convening closed in July. This was the work from OHCS in partnership with ODVA and ten communities around the state, working to end veteran’s homelessness. *******************Break**********************

Workgroup and Old Business: • Advisory Committee Workgroup combined with OLD BUSINESS • Final Vote on keeping the advisory committee meetings on Wednesday, with the June meeting in the afternoon to try a better time was had and passed.

• Guidance to subcommittee members:  Two primary areas of concern: 1) Housing 2) Healthcare  1 or 2 members to talk about what is going on in their area on in regards to the subcommittee topics at meetings  Share success stories and challenges from committee members’ counties * Housing Subcommittee Members: John Howard, James Gardner, Val Valfre, Rosy Macias, Dennis Guthrie * Healthcare Subcommittee Members: Reyn Leno, Bob Van Voorhis, Christine Gittins, Nell Stamper • Re: Healthcare –invite the Fed VA to come and brief on the Mission Act and Blue Water Navy at December meeting New Business • Transportation for veterans: how can the grant program for transportation be expanded? This still continues to be an issue for veterans getting to and from medical appointments. Expanding the verbiage to allow for cross county transportation.

• Operation Welcome Home Convening, great opportunity for Advisory Committee to get out and see what is happening and hear from the communities that take part in it.  The challenge was to house 500 homeless veterans and 580 were housed  New housing being opened up, permanent and transitional in collaboration with the local community action agencies • Warming Centers/Shelters, the need for more in more communities is greatly needed

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The 41st Infantry Brigade Combat Team from the Oregon Guard will have deployed before the nest meeting. (over 1,000 Soldiers from Oregon)  Keep them and their families in your mind, they will need help from the community with all different sorts of things Next Advisory Committee Quarterly Meeting: Date: Wednesday, December 4, 2019 | Time: 9:30 AM – 12:00 PM Location: Department of Public Safety Standards and Training | 4190 Aumsville Hwy SE, Salem, OR 97317

Chair Howard - Meeting adjourned at 1230.

Open for Public Comment

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The Following Pages Includes Today’s Meeting Reports

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ODVA DIRECTOR’S REPORT Kelly Fitzpatrick

As the end of calendar year 2019 fast approaches, ODVA has continued to be central to the success of many exciting programs, activities and events to serve, honor and advocate for Oregon veterans and their families.

Initiatives and Outreach Veteran Day - One of the many things that makes our country great is that so many Americans voluntarily serve in the military. They willingly set aside some of their own freedoms for a time to defend those of others. For this reason, ODVA puts a lot of emphasis on celebrating and honoring veterans and their families every year on Veterans Day. This year was no exception.

ODVA celebrated Veterans Day with its first-ever agency-wide event to honor our own employees and veterans. I also had the pleasure of speaking with Lottery employees about the partnership between ODVA and Lottery and the good work we do together for veterans using Lottery Funding. I was honored to attend the Veterans Day ceremony in Albany on a gorgeous early morning and then participate in the Albany Veterans Day parade before wrapping up the day at ODVA’s own statewide celebration at the Oregon WWII Memorial in Salem.

41st Infantry Brigade Combat Team Mobilization Ceremony – As elements of our Oregon Army National Guardsmen deployed in support of overseas missions across the world, ODVA participated in the Yellow Ribbon pre-mobilization events. At those events ODVA informed members of the 41st IBCT not only about their veterans benefits but also about the importance of promptly notifying the VA of their deployment status in order to avoid overpayments, for those soldiers who are currently receiving VA benefits.

Women Veterans – In November ODVA’s Women Veterans Coordinator was invited to speak at the USDVA’s 25th Anniversary of the Center for Women Veterans in Washington, D.C. about Oregon’s “I Am Not Invisible” exhibition. This very successful awareness campaign has gained national recognition with 28 states and the federal VA replicating the campaign featuring their own women veterans.

Tribal Veterans - In October I had the pleasure of participating in a tribal veterans’ event hosted by the Cow Creek Band of Umpqua Tribe of Indians. I had the opportunity to talk about the work ODVA is doing with the tribal nations to further access to veteran benefits and health services on tribal lands. The collaborative work that ODVA accomplished in 2019 is a culmination of years of effort and intentional engagement by ODVA and the tribes to enhance tribal veterans’ access to their earned VA benefits.

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ODVA DIRECTOR’S REPORT Kelly Fitzpatrick

Legislative Update During September and November Legislative Days I briefed the House Veterans and Emergency Preparedness Committees on ODVA’s efforts to recruit and fill vacant positions. I also joined some of our agency partners to present briefings to multiple legislative committees. I briefed on veteran housing challenges with Oregon Housing and Community Services and on the recently released report about veteran’s behavioral health needs with the Oregon Health Authority. Largely because of the nature of the short legislative session starting in February, ODVA will not be advancing any agency legislation, but will continue to push forward on implementing the new and expanded programs from the 2019-21 Legislatively Adopted Budget.

Program Highlights Annual VSO Training and Certification Conference – ODVA’s largest training conference to date was held in October with more than 115 attendees. Thanks in part to receiving additional Lottery funding to the counties for veteran services and additional funding for the conference, the training team enhanced the conference format to include 11 external partners, attendance

by Oregon’s first ever Tribal Veteran Services Officer from the Confederated Tribes of the Umatilla Indian Reservation and participation by a federal VA judge and The National Veterans Legal Service Program.

In addition, the conference hosted a Mental Health Crisis Trainer from Department of Public Safety Standards and Training (DPSST) to train CVSOs on how to help claimants experiencing mental health crises.

Partnerships Highlights Housing - ODVA’s partnership with Oregon Housing and Community Services (OHCS) to improve outcomes for veterans by functionally ending veteran homelessness in Oregon has proven to be effective. During the 2017-19 biennium, $1.5 million was allocated to OHCS to invest in the development of programs and resources to house veterans by bringing together networks of providers in key resource areas that support not only housing, but also the wraparound services that keep veterans stable and in their homes. Following a nearly year-long engagement between agencies and community partners, as noted above, ODVA and OHCS briefed the legislature about the progress that has been made to secure permanent housing for nearly 600 formerly homeless veterans.

Behavioral Health - Lottery Funding from the 2017-19 biennium partnered ODVA with Oregon Health Authority to study the behavioral health needs of Oregon veterans. The resulting study, conducted by Portland based Rede Group, was released in July with findings and recommendations that will help shape behavioral health services and resources for veterans in the future. ODVA and OHA hosted 16 forums across the state through October to share the

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ODVA DIRECTOR’S REPORT Kelly Fitzpatrick

study’s findings and recommendations and engage with veterans and service providers. And as noted above, this was the topic of a joint presentation to the legislature.

As always, I am so grateful for having an extraordinary ODVA team, and for the support of all of our partners who work with us every day to ensure veterans and their families thrive in Oregon.

Thank you, and I look forward to continuing our partnerships as we sustain our ongoing programs and implement exciting new programs in this biennium.

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Legislation, Administrative Rules and Agency Policy Laurie Skillman, Senior Policy Advisor

Oregon State Legislature: Background, Types of Legislative Sessions and the 2020 Short Session Background. The Oregon Legislative Assembly is bicameral, consisting of an upper house and a lower house. The upper house is the Senate with 30 members who serve four-year terms, and the lower house is the House of Representatives with 60 members who serve two-year terms.

Each Senate district is composed of two House districts. Senate District 1 contains House Districts 1 and 2, Senate District 2 contains House Districts 3 and HD 4, and so on. The legislature is termed as a “citizen’s assembly,” which means that most legislators have other jobs.

Until 2012, the Legislature met in “regular sessions” during odd-numbered years. The Oregon Constitution was amended in 2010 (Ballot Measure 71) and the schedule of regular sessions changed from bi-annual to annual. Effective 2012, the Legislature moved to annual sessions, with odd-numbered years for “regular session” that is limited to 160 days and begins in January, and even-numbered years for a “short session" limited to 35 days and begins in February.

2019 “Regular Session”: January 22, 2019 to June 30, 2019. During the 2019 regular session, major bills were passed and the Legislature passed a two-year budget that runs from July 1, 2019 to June 30, 2021. During the 2019 session, 2,768 bills were introduced; of these bills, 632 were signed by the Governor “Interim.” The time in between sessions is the “Interim”. The Legislature convenes periodically during the interim for “Legislative Days” that are scheduled approximately every eight weeks and last for four days.

Scheduled Legislative Days During the Interim Period: July 2019 to February 2020 During Legislative Days, Committees hold informational hearings on topics that may lead to legislation in upcoming sessions, hear updates on previous implementations, hear reports from state agencies and Task Forces, and keep current on the subject areas affecting Oregonians. The Senate may also convene for the purpose of confirming the Governor's executive appointments. No bills are heard or passed during Legislative Days. Legislative Days are scheduled for: September 16-18, 2019 November 18-20, 2019 January 13-15, 2020

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Legislation, Administrative Rules and Agency Policy Laurie Skillman, Senior Policy Advisor

2020 “Short Session”: February 3, 2020 to March 8, 2020 The 2018 Session will begin Monday, February 3, 2020 and end no later than Sunday, March 8, 2020. Compared to the number of bills filed in a regular session, there are usually only roughly 10% of the number of bills filed in a short session. For example, during the 2018 “short session,” 232 bills were introduced and 122 of these became law.

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FINANCIAL SERVICES DIVISION

Bruce Shriver, Chief Financial Officer

Issuance of $29 million of State of Oregon, General Obligation Veteran Bonds During October 2019, the Department entered the capital markets to issue approximately $29 million (par value) of general obligation veteran bonds which produced approximately $30 million of bond proceeds from this sale.

The $30 million of bond proceeds will be blended with approximately another $2.8 million of existing resources to produce total available lendable funds of approximately $32.6 million. These lendable funds will be used to originate or purchase veteran home loans for veterans that apply for their home loan within 25 years of their date of discharge from military service.

The Department will most likely return to the capital markets to raise additional lendable funds for veteran home loans in calendar year 2020. The timing of the next bond sale will depend in part, on veteran demand for home loans and general capital market conditions.

FY 2019 Audited Financial Statements The audited financial statements show an overall increase in net position in the Veterans’ Loan Program of approximately $3.6 million for the full twelve months of fiscal year 2019. The same period for the prior fiscal year showed an overall increase in net position of approximately $9.1 million. The current fiscal year increase in net position is primarily attributable to a reduction in excess mortgage interest (which increased current period loan interest income), interest earnings from the loan portfolio, higher investment income, and increased leasing and other income.

The Veterans’ Home Program audited financial statements show an overall increase in net position of approximately $4.7 million for the full twelve months of fiscal year 2019, compared to an increase in net position of approximately $4.9 million for the same period of the prior fiscal year. Included in these figures were transfers and capital contributions into the Veterans’ Home Program from the Veterans’ Home Trust Fund, Article XI-Q bond proceeds and federal grant monies which totaled approximately $2.3 million and $2.8 million respectively in fiscal years 2019 and 2018.

Both the Veterans’ Loan Program audit and the Veterans’ Home audit resulted in “clean” opinions from the external auditors with no qualifications noted in their stated audit opinions. Copies of the audited FY 2019 financial statements as well as other reports can be found on the Department’s website at the following link: https://www.oregon.gov/odva/Connect/Pages/Reports.aspx The Changes in Net Position for both the Veterans’ Loan Program and Veterans’ Home Program are shown in comparative form in the chart below.

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FINANCIAL SERVICES DIVISION

Bruce Shriver, Chief Financial Officer

Other Financial Services Division Activities: Over the past several months, the Financial Services team worked on contracting & procurement efforts, processed federal grant reimbursements, helped coordinate an internal audit review, conducted post-issuance bond compliance activities, exercised early bond redemptions, worked on the Fall 2019 bond sale, interacted with the Department of Administrative Services - Chief Financial Office and the Legislative Fiscal Office on budgetary & legislative matters, provided information to external auditors for the annual financial statement audits (Veterans’ Loan Program and Veterans’ Home Program), and performed other related financial activities as needed.

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AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director General AVS Update • •

• • • • •

Ana Potter and Kelly Breshears presented information about Aging Veteran Services programs at the annual County Veteran Service Officer Conference.

Mark Newell and Ana Potter, along with several volunteers, attended the 15th Annual Willamette Master Chorus Veterans Day Concert. It was held on two days, in Salem. There were over 800 people in attendance for both days. ODVA (AVS) and Marion County VSO’s had a booth outside the concert hall and Ana presented about ODVA/Veterans Benefits and the Volunteer program on both days.

Ana, Kelly and Helen Ireland attended the Elder Abuse Conference in late October.

Ana was a panel member for Sen. Wyden’s Town Hall in Roseburg.

Ana attended two of the Behavioral Health Forums. One at The Dalles, and the other in St. Helens.

She also attending the Behavioral Health in Long-Term Care Stakeholder meeting with DHS. Ana attended the recent medal ceremonies at both of the Homes and was present for the 5th year anniversary celebration for the Lebanon Veterans Home.

We are working to fill a vacancy left by Brittany Melzer in the front desk reception area. Brittany is currently on a one-year job rotation. We will be filling this position with a Limited Duration employee as she could possibly be returning to this position.

Special Projects: • Kelly Breshears continues to work with the IT and Communication units as well as the Project Management team to move forward with the replacement of the existing IT Conservatorship System.

Aging Veterans Outreach Lacey Carter Lacey spent several weeks assisting residents and staff while covering the Program Director position at the Oregon Veterans’ Home in The Dalles.

The Veteran Volunteer Program and Aging Veteran Outreach Program often intersect in outreach, event attendance and information. Fortunately, there were several events this quarter where the Veteran Volunteer Program Coordinator and Aging Veteran Outreach Specialist were able to attend together, to include: Portland Stand Down, Lebanon Senior Center Resource Fair, Oregon Scam Jam in Salem and the AARP Event, Stealing Your Life: An Evening with Frank Abagnale.

Lacey had the opportunity to represent ODVA Aging Veteran Services at a Veteran Day Social hosted by the Aumsville Oregon Veteran Group. There were around 35-40 people at the event which included a catered dinner, music and resource tables hosted by representatives from Project Able, the Marion County CVSO and American Legion. Aumsville City Councilman Gus Bedwell and Representative Paul Evans were in attendance. Representative Evans briefly spoke.

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AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director Lacey also attended the Veterans’ Services Information Tent at Chinook Winds for the annual Celebration of Honor event there. The event featured the Field of Honor, Oregon KIA Memorial Wall, ‘Wall of Honor’ (Iraq and Afghanistan), Living Military History Weapons Display and Uniform Display.

As an accredited Veteran Service Officer responsible for the claims and benefits counseling of the veterans and their families served in our Oregon Veterans’ Homes, Representative-Payee and Conservatorship programs, it is essential that the Aging Veteran Outreach Specialist stay informed and knowledgeable with regard to changes in veterans’ law, USDVA events and news and veterans’ issues and topics but also strive to be subject-matter-expert on aging and aging in relation to veterans. To that end, Lacey attended the Fall CVSO Conference, Fair Housing and Landlord Tenant Law Training, the Governor’s Commission on Senior Services Public Meeting and Listening Session, OHCA Annual Convention and Trade Show, Oregon Gerontological Association 2019 Conference as well as webinars on Strategies for Reducing Suicide in Older Adults, Working in a Meaningful and Impactful Manner with Older Adults, and Palliative Care Family Meetings for People Living With Dementia.

Veteran Volunteer Coordinator Mark Newell The Veteran Volunteer Program (Pilot Project) has now been running for approximately 6 months. The programs goal is to educate aging Veterans about their potential earned benefits and then to connect these Veterans to their County Veteran Service Office. We do this by visiting long term care facilities as well as other places Veterans may gather.

We currently have 17 volunteers trained. We are in Clackamas, Polk, and Deschutes Counties. Volunteers have two tasks: One, to do group presentations at long term care facilities. Two, to do individual visits with aging Veterans.

Group Presentations: We have held 35 group presentations and have reached 548 people. Volunteers put in 63 hours to do these presentations. Here are the results of those presentations.

Number of Individuals

Type of services referred to 18

27

3

41 3

36

Spoke to

4 6

USDVA housing Transportation

Referred to CVSO

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County Medical State

AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director Individual Visits: In our individual visits we have reached 63 individuals. Our volunteers put in 45 hours to reach these individuals. Here are the results of those visits.

Of all 611 people that we reached, 65% were male and 35% were female. We identified two LGBTQ+ individuals.

What we’ve learned: Getting the people, we have contacted into see their county Veteran Service Officer is difficult. A simple conversation generally is not enough. We have now implemented a follow up program where we get contact information from these Veterans when possible and contact them to see if they followed through with making an appointment. Our goal is to be able to report on the outcome of this in the next advisory report.

Conservatorship Helen Ireland, Conservatorship Manager During this quarter, the Representative Payee program had a total of 114 cases and the Conservatorship program had a total caseload of 107 active cases.

In August one of our Trust Officers resigned. We opened a recruitment for the position and Kathy Boyle was offered and accepted the position. Kathy comes to ODVA with a strong legal background. She started on October 1st and is currently working towards getting the required certification as a National Certified Guardian. In the meantime, our lead worker, Jordan Killian, has taken over the duties of this caseload in addition to his property management duties.

In early August, Angela Brown was hired into the new Representative Payee position granted to the agency through the budget process and in September our first Representative Payee, Mariya Williams requested a change in position to receptionist at our ODVA front desk. This created a vacancy and Sharlane Keener, one of our Trust Officer Assistants has filled this position. The vacancy left by Sharlane’s move was opened and Christine Watson-Husky was hired to fill this position.

All staff attended an annual training event hosted by the Guardian Conservator Association of Oregon. Staff are required to complete at least 20 hours of training every two years to maintain certification as a Nationally Certified Guardian.

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AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director Conservatorship and Representative Payee Demographics 6

3 12

16

16

8 9

32

33 50

8 4

36

107

50

3 Nursing Home

Residential Care Facility

Adult Foster Home

Assisted Living Facility

Room & Board Facility

Hospital

Independent Living

Relative Care

Incarcerated

Homeless

WWII

Korea

Vietnam

Peace Time

Gulf War

Other (non-veteran)

(Note: some veterans have served in multiple campaigns of war/branches.)

Oregon Veterans’ Home, Lebanon Jeremy Woodall, Program Director State Survey and Recognition As a State Veterans’ Home (SVH) recognized by the Federal VA, we have two annual surveys. One by CMS (Centers for Medicare and Medicaid Services) and a federal survey by the USDVA (United States Department of Veterans’ Affairs). The state survey happened at the OVHL from 30 SEP to 7 OCT (the previous state survey was in February 2018) and went very well.

The Lebanon Veterans’ Home was awarded the Silver Quality Award from the American Health care Association. Only 10 long-term care facilities in Oregon were awarded this prestigious award. These awards are progressive and show the facility’s commitment to quality.

Veterans Day Events Veterans Day is an important day for our veteran residents with many, many individuals and organizations from around the state coming to honor and bless our veteran residents. All staff are busy working with our guests to assure our veteran residents are safe and that the donations provided get distributed effectively and efficiently.

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AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director Volunteer Appreciation Dinner Several weeks ago, the Recreation Department hosted an appreciation dinner for the volunteers at the OVHL. Truly these are the folks who really make the meaningful life events and experiences happen that bring so much value to our veteran residents. 55 guests attended, and Bess Broce, Volunteer Coordinator of the OVHL, awarded several with unique signs of appreciation.

Medals Presentation At the time of this writing the OVHL is planning a medals presentation for 10 of our deserving veteran residents. This event, hosted at the OVHL quarterly, is greatly supported by the efforts of Mike Allegre from West Care. Jeremy will be assisting Mr. Jim Sparkman, Command Sergeant Major of the U.S. Army Reserves, in presenting the medals. The same event Mr. Greg Caldwell, Honorary Consul for the Republic of Korea in Northern Oregon, will be presenting a Korean Ambassador for Peace medal to one of our veteran residents.

It’s Beginning To Look A Lot Like Holiday Season Recently a team of workers descended upon the OVHL and hung lights and wreaths around campus.

Definitely one of the nicest decorated facilities in the community! (Watch Facebook for posts showing off the lighting!)

OVHL Demographics 2 11

8

18

22

21

39 38

65

65

13 1

WWII

Korea

Vietnam

Air Force

Army

Coast Guard

Peace Time

Gulf War

OIF/OEF

Marine

Navy

Spouse

(Note: some veterans have served in multiple campaigns of war/ branches)

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AGING VETERANS’ SERVICES

Ana Potter, Director Kelly Breshears, Assistant Director Oregon Veterans’ Home, The Dalles Melissa Craig, Program Director Melissa Craig, who was hired in October to fill the Program Director vacancy, has begun her training to be a VSO as well as training specific to care in a nursing home. Jeremy has spent time with Melissa reviewing the systems and processes he has in place to effectively lead the oversite of the facility and advocacy efforts of the veteran residents at the OVHL. Melissa also attended the CVSO conference and will be attending several other trainings to prepare her for this position.

Melissa also attended the recent medal ceremonies at both Homes and spent a week up in The Dalles with Lacey Carter who has been helping cover while the position was filled.

OVHTD Demographics 2 15

19

18

28 26

28 56 7

57

WWII

Korea

Peace Time

Gulf War

Vietnam

4

Air Force

Army

Coast Guard

Marine

Navy

Spouse

(Note: some veterans have served in multiple campaigns of war/ branches)

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STATEWIDE VETERAN SERVICES Sheronne Blasi, Director

PROGRAMS Statewide Veteran Services (SVS), Portland Office—Martin Ornelas During the quarter, SVS Portland staff attended 95 Travel Board and Video hearings and 24 DRO hearings, and reviewed 4,280 Ratings Board decisions. They are continuing to work hard to catch up with and stay current with scanning and uploading documents issued in response to veteran claims, while providing the assistance for appeals work needed by Oregon Counties.

The Portland office is currently in the process of recruiting and hiring another Veteran Services Officer (VSO).

Training, Certification and Outreach (TCO)—Joe Glover and James Connolly ODVA’s Training team just concluded the 2019 Annual Veteran Service Officer Training Conference, held in beautiful Welches, Oregon. Approximately 120 county, tribal, and national service organization Veteran Service Officers attended. Both Veterans Health Administration and Veterans Benefits Administration officials participated in a discussion panel with our attendees. This year we also invited members of our Oregon Legislative committees to attend and participate in a discussion panel. National Veterans Legal Services Program (NVLSP) provided detailed trainings on core subjects, as well as providing an update regarding the agreement with ODVA/Oregon Counties and how NVLSP is continuing to represent Oregon veterans before the Court of Appeals for Veterans Claims. This year we expanded our ‘Choose Your Own Adventure’ break out/mini session day with over 15 local and national organizations offering programs that can impact the lives of Oregon veterans. Presenting current, broad spectrum information to VSO’s who function as the initial inquiry point for veterans is critical to ODVA’s mission success. We tested seven trainees that will continue on their training pathway and accredited one new CVSO. Women Veterans Coordinator—Liz Estabrooks This quarter Liz had 38 veteran contacts; 12 community partner meetings; five education presentations, including two VA Mental Health Summits; seven Behavioral Health Forums; consulted or partnered with the Portland VA at four different meetings, including as part of the MST/PTSD Task Force and planning for the MH Summits; attended two Oregon DHS DV Council meetings; had three phone calls with one congressional veteran rep; attended three veterans outreach events plus two Stand Downs in (Bend and Warrenton) and a Sisters in Arms event, meeting over 100 women veterans plus 15 family members of women veterans; one professional development event; a group session with women veterans at the Portland Vet Center attended by eight women veterans; and expanded planning on the 2020 Oregon Women Veterans Conference.

Success story: One of the first women Liz met when she started at this position had been denied her MST related PTSD claim in 2009. She wanted to try filing again but has been putting it off since 2016, because it is such an intense, emotionally difficult process. Liz has stayed in touch with her, helping her find treatment, working with her as she connected with VA providers, and meeting with her every time she said she was ready, no matter how many times she changed her mind. In February she entered a residential treatment program, contacted Liz, and together they met with a VSO and filed her claim. Although the claim has not yet been 28

STATEWIDE VETERAN SERVICES Sheronne Blasi, Director

adjudicated, just getting her to the point where she filed is a huge success. She was just notified that the C&P exam is upcoming, and Liz will be attending as support.

LGBTQ Veteran Coordinator—Nathaniel Boehme ODVA’s LGBTQ Veterans Coordinator maintained a high public profile with a notable presence at the Portland Veteran Stand Down, ODVA Expo, as well as supporting a Yellow Ribbon predeployment event. Claims work continued with veterans commenting on the level of attention to detail and passionate advocacy provided.

Success Story: ODVA’s LGBTQ Veterans Coordinator was able to respond in a very short timeframe in conjunction with the Molalla Police Department to a veteran in crisis and worked to support that veteran through the ensuing weeks. Additionally, ODVA’s LGBTQ Veterans Coordinator had a direct role in close partnership with local SSVF providers that led to two veterans who were experiencing homelessness establishing permanent and stable housing.

Incarcerated Veterans—Pat McGuffin and Shane Hagey We successfully recruited to fill our second Incarcerated Veteran Coordinator position. Shane Hagey comes to us from Sponsors Inc. in Lane County where he worked as a Program Director managing their permanent supportive housing program focused on assisting those needing reentry housing and a wide array of wrap-around services. He also has 30 years of public safety experience including time in corrections, parole and probation, law enforcement and several management positions in these areas.

Having two coordinators on staff has allowed us to increase visits to local facilities. We recently met with veteran groups at Oregon State Correctional Institution, Oregon State Penitentiary, and staff members from the State Hospital and the Department of Corrections (DOC) to identify ways to better serve patients at the hospital and incarcerated veterans. One particular area of focus is documenting the best way for USDVA officials to contact prison staff to schedule Compensation and Pension examinations at each DOC facility. This will help more veterans become service-connected and ultimately provide them with more resources upon reentry.

Success story: Pat received notice from the USDVA concerning two claims improperly filed by veterans at Snake River Correctional Institution (SRCI) slated for denial without processing. He was able to work with a new Veteran Benefit Specialist, an inmate selected by SRCI leadership (and approval by ODVA) to assist fellow veterans with claims work, to address the shortfalls on the claims previously submitted. This approach allowed quick resolution of the errors without an in-person visit to the facility and provided good learning opportunities for the new specialist. It also allowed the claims to proceed without being denied before evaluation or loss of the original effective date should the claims ultimately be successful.

Tribal Veteran Coordinator— (roles currently assumed by SVS Director) ODVA continues to reach out to tribal leadership of the nine federally recognized tribes regarding new funding to assist in providing veteran VA benefits and claims representation.

29

STATEWIDE VETERAN SERVICES Sheronne Blasi, Director

ODVA will partner with tribal governments with which we have a Memorandum of Understanding (MOU) on standing up an office, hiring staff, etc. ODVA will, as with the CVSOs, provide training, certification towards accreditation, counsel, and outreach.

We currently have an MOU with the Confederated Tribes of the Umatilla Indian Reservation, and they have hired a Tribal Veteran Service Officer (TVSO) who is working toward accreditation. ODVA also has an MOU with the Confederated Tribes of Warm Springs, and they are in the process of hiring a TVSO. We have presented information about the TVSO program at several other tribal council meetings and the Legislative Council on Indian Services.

State Approving Agency (SAA) – Kim Douthit and Lisa Deneen The Veterans’ Education Manager/Interim SAA Director, Kim Douthit, and SAA Compliance Specialist, Lisa Deneen, were able to connect with the VA Education Office and VA Central Office to secure a partial SAA contract through September 30 (the end of the VA fiscal year). This allowed ODVA to partner with VA to create a plan for transitioning the SAA function from the VA, who had been filling the role for FY19, to ODVA. They attended the National Association of State Approving Agencies (NASAA) Summer Conference in Omaha, NE where they connected with SAA counterparts in other states as well as VA staff. ODVA signed a full contract with the VA, and assumed the SAA duties on Oct 1, 2019 – the start of the VA Fiscal Year.

Grants Management—Sue Farkash Emergency Financial Assistance Eighteen applications for grants were received, with five of those approved for a total of $16,100. The average grant was $3,220. Most approved grants are for mortgage/rent and utility payments.

Success story: A disabled veteran was unable to secure affordable housing due to a debt incurred at his last rental. He had completed several programs to get his life on track, and had obtained a housing voucher for affordable housing but could not utilize it with an outstanding debt. The grant paid the debt, and the veteran is now in a secure, permanent home.

Highly Rural Transportation Grant Ten highly rural counties are receiving assistance transporting veterans to VA medical appointments. The grant has been a successful cooperative arrangement between USDVA, ODVA, and rural counties and their transportation entities.

Success story: This quarter, ODVA applied for and was granted funds for a sixth year. During the federal FY19 grant (which just closed), over 290,000 miles were driven, on 3,800 separate trips, taking Oregon veterans to vitally needed medical appointments.

Campus Veteran Grants The Campus Grant Coordinator position is currently vacant.

30

STATEWIDE VETERAN SERVICES Sheronne Blasi, Director

Success story: Chemeketa Community College recently worked together with Oregon State University, Western Oregon University, and Corban University to assist veterans at all four schools to learn how to transfer credits and majors between schools as seamlessly as possible.

The four schools are all in the same general geographic area, so movement between them as majors change or general education requirements are met, is quite common. Losing credits in a transfer is a major problem, and a reason why some students leave school, so for the 30 attendees it was a huge help.

Statewide Veteran Services Grants The 10 selected grants have been busy implementing proposed programs and serving veterans.

For the grantees that have been unable to expend their full grant funding, six month extensions were offered. Grantees are in the process of evaluating their spending and requesting extensions.

Success story: Lane Council of Governments received a grant to support a part-time veteran benefits navigator, with a goal of reaching 100 unique veterans in the county and connecting them with resources and federal, state, and local benefits. The navigator worked hard at building a network of resources, and learned many of the processes involved with working the federal VA system. She met with veterans in their homes, set up meetings, and often accompanied veterans and their family members on appointments after helping them to gather the necessary support documentation to successfully meet with the planned provider. They ended their grant at 100% spent out, and well over their original goal of 100 veterans by serving 172 unique veterans in Lane County.

Lines for Life Lines for Life, provides 24-hour phone and text services to at-risk veterans and their families.

This quarter, 932 calls from fourteen identified counties were logged. The calls had an average wait time of 27 seconds, and the average duration of a call was 11 minutes. Referrals were given to 21% of the callers for mental health appointments, drug and alcohol treatment, and assistance with the VA. Emergency services were not notified for any calls this quarter.

Partnership with Oregon Housing & Community Services (OHCS) ODVA Director co-presented on the outcomes of Operation Welcome Home with the Director of OHCS and the OHCS Homeless Veterans Integrator at the September Legislative Days – House Veterans & Emergency Preparedness Committee.

Partnership with Oregon Health Authority (OHA) – OHA and ODVA have been working together on the Veterans Behavioral Health Services Improvement Project, the first phase of which was the completion of a study and report describing the current landscape of veterans’ behavioral health care and providing recommendations for future improvements. The study was conducted by the Rede Group, that also conducted the Women Veterans study a couple years ago.

In the second phase of this project, OHA, ODVA, and Rede Group have facilitated and attended a series of community forums on veterans’ behavioral healthcare around the state of Oregon.

31

STATEWIDE VETERAN SERVICES Sheronne Blasi, Director

The first part of the session emphasizes introducing the report and gathering input from veterans and the community and the second part was geared towards professionals and policymakers working in veterans’ behavioral health although anyone is welcome to attend any portion of the forum. The forums have provided feedback on the report, as well as feedback on priorities for the recommendations contained in the report.

Partnership with Oregon National Guard (ONG) – Over the last several months, SVS staff have presented at numerous ONG pre-deployment Yellow Ribbon events across the state. These are in preparation for current/upcoming deployments of approximately 1,500 ONG men and women. The focus has been to encourage Guardsmen and women who are currently receiving federal VA monetary benefits (from prior deployments/active duty), to turn off those benefits while deployed so they do not end up in an overpaid status upon return to Oregon.

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Veterans’ Home Loan Program Second Quarter 2019 Cody Cox – Home Loan Program Manager

Production Review •

• • •

The interest rate environment for the Home Loan Program for calendar year 2019 has remained challenging.

With the record production year for 2018, 3rd Quarter 2019 production is minimal when compared to the same quarter in 2018. Remember, the 3rd Quarter of 2018 was the highest production record back through 1997. Because of that, 2019 production numbers are uncharacteristically low.

For the 3rd Quarter, 2019, the Home Loan Program closed 33 loans for a gross dollar volume of $11,335,579.

For the same period in 2018, the Home Loan Program funded 118 loans for $33,695,212.

Year to date, the OrVet Home Loan program has funded 86 loans for $27,695,224.

The chart below shows a 2014 - 2019 YTD monthly production comparison of dollar volume funded for the OrVet Home Loan program.

$16,000,000 $14,000,000 $12,000,000 $10,000,000

2014

2015

2016

2017

2018

2019

$8,000,000 $6,000,000 $4,000,000 $2,000,000 $-

•

At the end of the 3rd Quarter 2019, ODVA has a total of 1,877 loans in portfolio, with a total dollar amount under servicing of $361,325,834. Of these, 1,676 units and $353,639,225 are new loans. Old loans were at 201 units totaling $7,686,609. At the end of the 3rd Quarter 2018, the ODVA had a total of 1,935 for $353,905,402 under servicing; with 1,670 units at $344,410,624 as New loans and 265 units at $9,494,777 were Old Loans. Portfolio runoff continues due to a favorable rate environment and a reduction in new originations.

Loan Delinquency Review • • • •

For the reporting period of 09/30/2019, there was no State Owned Properties/Real Estate Owned (SOP/REO) in inventory.

At the end of 3rd Quarter 2019, there were no loans in a Foreclosure status.

At the end of 2nd Quarter 2019, ODVA has 2 loans in a bankruptcy status; a reduction of 1 unit from the prior Quarter.

The total of all loans reporting in the 90-day or greater delinquency position was at 7, expressed as 0.4% unit delinquency on a portfolio of 1,877 loans and at 0.1% per dollar amount under portfolio.

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Veterans’ Home Loan Program Second Quarter 2019 Cody Cox – Home Loan Program Manager

•

ODVA continues to experience reduced delinquency rates as compared to other Government Residential Loan Programs. The Mortgage Bankers Association publishes a quarterly National Delinquency Survey and the following represents Oregon specific comparative data from the most recently available Third Quarter 2019 report. The delinquency rate expressed as a percentage of total loans (units) past due for the Federal Veterans Affairs home loan program in Oregon was 2.93% (up slightly from the previous quarter), FHA home loans in Oregon were at 5.64% (down slightly from the previous quarter) and Conventional Prime home loans Oregon were at 1.60% (down from the previous quarter). For this reporting period, the total delinquency for the ODVA home loan program was 1.2% at 22 units.

Quarterly Staffing News After many quarters of staffing inactivity, we had 3 staffing changes in the 3rd Quarter, 2019.

First, Tami Leest announced her retirement after 41 years of service to ODVA. Tami was our tax & insurance technician, and a resource of history and information to the agency. We have retained Tami as a contract employee to assist the annual property tax payments that occur in mid-November annually.

Second, after almost 6 years with the Agency, Devon Thorson transferred over to a different agency. Devon was our in-house attorney, that handled all the Loan Department’s bankruptcy and foreclosure duties.

Finally, Tai Broom, who covered our transfer and payoff requests, relocated out of state to be with family.

We thoroughly enjoyed each of these employees and wish them well in their next phase. They will be missed.

Cody L Cox Home Loan Program Manager

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FACILITIES AND CONSTRUCTION John Osborn, Program Manager

THE DALLES VETERANS’ HOME The MOU for the Dalles project has been signed and return, this gives us the ability to submit for reimbursement of project expenditures. The overall project will involve replacing the roof, redesigning the soffit to siding connections; redevelop the garden area between C & D wings, and various interior and exterior items. The contractor has begun mobilization and acquiring the materials for the project.

All materials will be on site by early spring and work will commence thereafter. All work should conclude be the end of September 2020. The total project cost has been reduced, the total cost is now; $3,878,372. Federal share is $2,519,642. State is $1,356,730.

LEBANON VETERANS’ HOME In late September ODVA received word from USDVA that grant funding will be made available for the Lebanon project. We will need to complete the remaining items on the checklist by March of 2020.

These efforts have already begun and we should complete outstanding items well before the deadline.

As a reminder, the project is to further develop the area west of the new parking lot adding a storage building and additional staff offices. In addition, an activity room will be built off the existing D-wing spine, similar to the one constructed at The Dalles Veterans Home. The total project cost is $3,649,000.

Federal share is $2,371,850. State share is $1,277,150.

ODVA Building The remodel work on the first floor is moving forward at a good pace. The carpet shipment has been delayed which will delay completion on the first floor about three weeks. The delay will affect Aging Services and Veterans Services which will occupy the east side of the first floor, the westside of the first floor will be occupied by Oregon Housing and Community Services (OHCS). Suite 230, which OHCS will be acquiring has also been delayed due to egress issues with city and fire marshal. Once these problems have been resolved the remaining work will be completed.

The third-floor interior refresh of suite 340, vacated by OHCS, will be occupied by Early Learning Division (ELD). The work in this area has been finished and workstation installation is pending.

All remodels in the building will include additional offices, new carpet, flooring, paint, and casework.

The updated finishes and furniture will create a more welcoming atmosphere in the lobby and through-out the building.

35

36

Date: December 4, 2019 To:

ODVA Advisory Committee Members Kelly Fitzpatrick, ODVA Director

From: Gus Bedwell, Veteran Housing Integrator, Oregon Housing and Community Services Sam Kenney, Homeless Services Policy Analyst, Oregon Housing and Community Services Re:

OHCS Veteran Initiative 2020

Purpose:

Informational briefing to the Housing Stability Council on the recommended next steps to end Veteran homelessness in Oregon

Summary and motivation In 2016 the Oregon Legislature referred Measure 96 to voters and it passed with an overwhelming majority. Measure 96 dedicates 1.5% of lottery bonds to Veteran services. In March of 2017, following the passing of Measure 96, Governor Brown charged the Oregon Department of Veterans Affairs (ODVA) and OHCS to marshal their resources and work in collaboration to end Veteran homelessness in Oregon. Subsequently, OHCS received $1.5M in one-time funds to house Veterans experiencing homelessness. Furthermore, the Statewide Housing Plan (SWHP) Homelessness policy priority declares a focus on serving Veterans experiencing homelessness.

Specifically, the SWHP recognizes best and promising practices—such as the United States Interagency Council on Homelessness (USICH) criteria on ending Veteran homelessness, collaboration with partners who serve Veterans, and coordination of funding sources—as paramount to achieving the 2019 – 2023 goal of ending Veteran homelessness in the State of Oregon.

These efforts commenced when Oregon Housing and Community Services (OHCS) in partnership with ODVA launched Operation Welcome Home (OWH). OWH was a nine-month campaign to assist ten communities in their work to house Veterans experiencing homelessness, establish a Veteran Leadership Team (VLT), and create a Veteran By-name List (VBNL). These goals derived from best and promising practices such as the USICH criteria on ending Veteran homelessness, lessons learned from states who have ended Veteran homelessness, and other successful national campaigns to end Veteran homelessness.

OWH Results and Feedback • The ten OWH communities housed 587 Veterans using diverse fund sources.

• Communities with robust VLTs and VBNLs most effectively serve Veterans experiencing homelessness.

• Most communities need hands-on HMIS/VBNL support to refine and share their VBNL. • Needs assessments should be conducted with communities prior to operationalizing Technical Assistance (TA).

Oregon Housing and Community Services | 725 Summer St. NE Suite B, Salem, OR 97301-1266 | (503) 986-2000 | FAX (503) 986-2020

• One-size fits all TA is not responsive to specific community needs and does not meet communities where they are.

• Communities expressed that OWH increased their workload but did not yield more benefits.

• Communities expressed a need for flexible resources to complement existing funds.

• Some participating communities experienced limited stakeholder engagement and insufficient collaboration from the necessary partners.

• OHCS recognizes that working with ten communities exceeded internal capacity to provide each community with adequate attention.

Strategy Proposal: OHCS Veterans Initiative 2020 Moving forward with our next Veteran initiative, we endeavor to build on Operation Welcome Home, integrate feedback, and make improvements. In practice, this means leaning into national best practices and drilling down into local challenges. Where OWH worked to fit communities to the TA, with the next campaign we recommend providing tailored, community specific TA. To incorporate and address community specific challenges and abilities, OHCS staff, in collaboration with each community, will conduct a Veteran services needs assessment. This assessment will identify where each community is at with their Ending Veteran Homelessness Infrastructure and will outline how OHCS can support their efforts.

The infrastructure each community should work towards constructing is: 1) a robust VLT where all stakeholders have a seat at the table, 2) a detailed VBNL, 3) a standing meeting where the VLT utilizes the VBNL to case-conference Veterans in crisis, and 4) offer the most appropriate resource to each Veteran. This foundation will position communities to create a sustainable system to serve Veterans at risk of or entering into homelessness.

After OHCS and the communities identify needs and challenges, we will work together to map out specific topics for TA and how to creatively utilize existing fund sources to fill gaps in the Veteran service system and move towards a more sustainable system. The graphic below illustrates levels where communities may be based on the needs assessment, in the work toward honing their Veteran service system.

Oregon Housing and Community Services | 725 Summer St. NE Suite B, Salem, OR 97301-1266 | (503) 986-2000 | FAX (503) 986-2020

Build the system

•Establish VLT lead and members •Establish VBNL in HMIS •Identify community specific challenges

Strengthen the system

•Add Veteran partners to HMIS •Consistent VLT meetings •Proposed action plan for specific challenges

Hone the system

•VBNL in HMIS with full partner access •VLT with extensive buyin, consistency, and caseconferencing •Community is actively addressing specific challenges

Funding As called out in the Operation Welcome Home feedback, communities face unique challenges and need specific TA—where the provider invests time and energy in the community—and additional resources to bridge gaps and meet needs. Furthermore, as previously noted, OWH served ten communities, which exceeded OHCS and the TA provider capability to allocate the necessary time and resources to each community. Considering this information, the goal is to target a smaller number of communities for the next campaign. To implement this strategy, OHCS will expect to utilize funds for TA and to allocate funds to each participating community to house Veterans, bridge service gaps, and build their Veteran service infrastructure. Participation in the campaign and access to funds will be competitive and will depend on meeting goals outlined in the community assessment and adherence to the Ending Veteran Homelessness Infrastructure.

Equity & Racial Justice Considerations The data collected from OWH communities during the campaign was used to create an OWH Dashboard. Note: the data collected was not standardized across communities and often did not include demographic details. Without individual level data, OHCS and partners cannot assess the specific needs and trends of communities of color.

Moving forward, OHCS will work with communities to align ongoing racial justice and equity work—such as the EPIC Outcomes Tool implementation—with Veteran work to incorporate best and promising practices and create a shared understanding of racial equity. Furthermore, OHCS is positioned to step-up our involvement in HMIS related challenges. Our goal is that all VBNLs will be housed in HMIS and future campaign reports will be sent directly to OHCS staff. This will

Oregon Housing and Community Services | 725 Summer St. NE Suite B, Salem, OR 97301-1266 | (503) 986-2000 | FAX (503) 986-2020

allow us to play an integral role in data quality, data sharing, reporting, and data visualization.

These are critical steps in understanding equity and racial justice considerations.

Discussion/Recommendation We are seeking feedback and buy-in from ODVA Advisory Committee on the direction of our next body of work.

Oregon Housing and Community Services | 725 Summer St. NE Suite B, Salem, OR 97301-1266 | (503) 986-2000 | FAX (503) 986-2020

OREGON VETERANS’

Behavioral Health Services Improvement Study: Needs Assessment & Recommendations Report

Executive Summary prepared by the rede group

in june 2019

REPORT SECTION - 1

Acknowledgments

June 2019

This report was produced by the Rede Group for the Oregon Health Authority and the Oregon Department of Veterans’ Affairs.

Thanks also to the United States Veterans Health Administration and all the health care providers who contributed invaluable information on current practices and data.

Submitted by:

In collaboration with:

Jill Hutson Alex Muvua Emily Drum, MPH Erin Charpentier, MFA Kate Marsi, MSW, MPH Stephanie Young-Peterson, MPH Robb Hutson, MA

Bonnie Gee Yosick, LLC ELE Consulting, LLC

Bonnie Gee Yosick, MBA Eric Einspruch, PhD

Acknowledgments:

Sheronne Blasi, MPA Royce Bowlin, MS David Greaves, PhD Holly Heiberg, MPP Michael Morris, MA Jeff Scroggin Laurie Skillman, JD Mitch Sparks Emily Watson, MPA

We gratefully recognize the contributions of these collaborators on this report:

This document can be provided upon request in alternative formats for individuals with disabilities or in a language other than English for people with limited English skills. To request this publication in another format or language, contact us at 503-3783486, email dhsalt@state.or.us or 711 for TTY.

Acknowledgments

Over the course of this project, 4,659 veterans gave their time and energy to inform this study. They completed surveys, shared their experiences in interviews, participated in photo shoots, and met for focus groups. They shared personal stories of illness, stigma, treatment, health, and recovery. Most of all, they shared their hope— hope for a better behavioral health system for themselves and for all the veterans who will follow them home.

We are profoundly grateful to each one of these individuals for their contributions to this study.

EXECUTIVE SUMMARY

REPORT SECTION - 7

Executive Summary INTRODUCTION Underscoring the state’s commitment to supporting the 10% of Oregon adults who have served in the U.S. military, the 79th Oregon Legislative Assembly prioritized the behavioral health of Oregon veterans by charging the Oregon Health Authority (OHA) and the Oregon Department of Veterans’ Affairs (ODVA) to identify and fund programs and services that improve their behavioral health outcomes. In response, OHA commissioned this report to assess veterans’ access to adequate and appropriate behavioral health services across the state.

The key findings in this study are derived from research conducted through literature review; analysis of national and state datasets; structured interviews with Veterans Health Administration (VHA) and non-VHA providers and local and national Tribal representatives; and a statewide online questionnaire survey and focus groups with Oregon veterans.

These findings highlight the unique issues Oregon veterans face in accessing behavioral health care, dispel some perceptions about veterans’ behavioral health while reinforcing others, and illustrate the ways in which the current behavioral health system impacts veterans and the providers who serve them.

SCOPE OF THE STUDY:

63

11

VHA providers interviewed

12

Non-VHA providers interviewed

Veterans participated in nine focus groups in five locations

3,915

Veterans from across the state completed online questionnaire surveys

EXECUTIVE SUMMARY - 1

PURPOSE OF THE STUDY: 1. To describe the type and availability of behavioral health services for veterans in Oregon 2.To provide findings regarding facilitators of and barriers to delivery and use of behavioral health services for veterans in Oregon 3. To make recommendations for legislative or other changes that may result in better delivery, accessibility, and utilization of behavioral health services by veterans in Oregon

Executive Summary KEY FINDINGS & RECOMMENDATIONS The findings and recommendations below are condensed from the final findings and recommendations of this report. Please refer to the full report for the complete findings and recommendations in detail.

Veterans’ role in designing systems improvements findings

■ Oregon veterans exhibit a strong desire to achieve behavioral health and wellness. However, the efforts of some are stymied by issues comprising two main categories: access and quality of care ■ Veterans express a strong desire to improve behavioral health conditions for future veterans

recommendations

By October 2019, OHA should present this report to veterans and key stakeholders at 15-25 small, community-based meetings throughout Oregon to share report findings and provide a forum for local-level problem solving 2. By June 2020, OHA should develop a mechanism to fund innovative, cross-sector, community-level projects that are designed to bridge gaps in services found in this report 3. By June 2020, ODVA and OHA should establish a veterans’ behavioral health commission which is chaired by a veteran and whose membership comprises at least 75% veterans, with representation from rural, women, Tribal, and LGBTQI veterans 1.

Consistent and sustainable coordinated access findings

■ Oregon currently does not have an adequate number of providers to support the behavioral health needs of the state’s veterans ■ Veterans who receive care through the VHA report slightly higher levels of satisfaction with services than those who receive care through other means ■ Some veterans’ trust in VHA behavioral health services has been undermined by the perception of a one-size-fits-all approach with an overreliance on pharmacological therapies, inability to choose their own providers, frustration with navigating logistics, and disappointment with previous VHA care experiences

recommendations

4.

OHA should continue to develop strong relationships with regional VA providers throughout VISN 20 EXECUTIVE SUMMARY - 2

Executive Summary KEY FINDINGS & RECOMMENDATIONS OHA, ODVA, and Portland VA Health Care System should collaborate to develop a comprehensive state- and federally-funded program to address veterans’ needs through transition back to civilian life 6. Cross-agency collaboration among OHA, ODVA, and VA Health Care Systems in Oregon should drive increase of state and federal agency coordination across behavioral health systems 5.

Outreach to improve access findings

■ Stigma around mental health and substance use is a major barrier to seeking behavioral health care for veterans. Stigma is embedded in military culture and communities-at-large and can be targeted at specific subgroups of veterans whose access to services may already be impacted by fear or discomfort in seeking services (e.g., women veterans, LGBTQI veterans)

recommendations

7.

OHA, ODVA, and the VA Health Care Systems in Oregon should collaborate to develop a cohesive, well-researched, and targeted education and outreach effort to destigmatize behavioral health issues and treatment using market tested, culturally-specific messages promoting care-seeking and demonstrating that Oregon is making veterans’ behavioral health care a priority. Minimally the outreach effort should include: ■ ■ ■ ■

Provider education Mass communication with formative research testing Programs highlighting and directing veterans to existing services Outreach to community groups

As a component of this effort, OHA and ODVA should collaborate on a one-stop website that provides veterans and their families with basic navigational support Quality of care findings

■ Both veterans and providers identify peer relationships as an essential aspect of behavioral health services ■ Coordinated Care Organizations (CCOs) and Community Mental Health Programs (CMHPs) provide important services that could benefit veterans but report concerns about the level and quality of care available to veterans

EXECUTIVE SUMMARY - 3

Executive Summary KEY FINDINGS & RECOMMENDATIONS recommendations

OHA should continue to develop and fund quality peer support models across the state and prioritize expanding culturally competent peer support for specific populations (e.g., rural, Tribal, combat, aged 34-and-under) 9. OHA should work with CCOs and CMHPs to collect veteran status data in Electronic Health Records and encourage and support CCOs in developing quality improvement strategies for veterans’ behavioral health services 8.

Cultural competency findings

■ Tribal representatives report a need for cultural competency in services, with an emphasis on a preference for traditional healing modalities and peer support as the most important factors in care-seeking behavior for Tribal veterans ■ Variances exist in the specific needs and expectations of subgroups of veterans (e.g., age, gender, LGBTQI identity, etc.) that impact how those veterans seek care ■ Some women veterans report that they are met with bias affecting their care when interfacing with VA Health Care facilities

recommendations

10.

The VHA and Vet Centers should promulgate plans to build capacity for cultural competency practices with measurable objectives that address the unique needs of groups of veterans

Provider outreach findings

■ The availability of publicly-funded non-VHA providers who are trained in the knowledge and skills to screen for and/or treat concerns specific to veterans and their families is limited, particularly in rural areas

recommendations

11.

OHA and ODVA should collaborate to increase the number of non-VHA providers with training in military or veterans’ behavioral health issues to improve veterans’ access to providers with the skills to identify their needs and to provide military trauma informed services

EXECUTIVE SUMMARY - 4

Executive Summary KEY FINDINGS & RECOMMENDATIONS 12.

OHA should conduct a review of evidence-based programs, such as the Star Behavioral Health Providers training, to offer providers a menu of programs that will provide them with the tools to provide culturally relevant care to individuals with military posttraumatic stress disorder (PTSD), traumatic brain injury, and military sexual trauma

Data and research findings

■ Some veterans’ behavioral health outcomes, when compared to those of non-veterans, are counterintuitive when considered in light of differences (or lack thereof) in behavioral health characteristics between the two groups. For example: · Veterans are less likely than non-veterans to report they have been told they have depression but more likely to die by suicide · Veterans and non-veterans have similar tobacco and alcohol use, but veterans are more likely to die in opioid-affiliated occurrences ■ Publicly funded non-VHA providers do not have comprehensive systems in place to identify veterans, a significant gap in access to quality data that impacts the state’s ability to evaluate improvements in behavioral health systems ■ More research into behavioral health conditions and treatments for veterans with other-than-honorable discharge (OTH) status is necessary in order to adequately serve this group ■ VHA providers report administrative and other challenges with the purchased and referred care systems. Providers at individual VHA facilities also report they are unable to provide some services that are considered essential to best practices for veterans’ behavioral health care

recommendations

OHA should further investigate age-specific trends in substance use and other suicide and opioid mortality risk factors, specifically in veterans aged 34 and younger. OHA should continue to monitor veterans aged 75 and older 14. OHA should establish data systems to routinely gather veteran status, health status, behavioral health, and health care information about Oregon’s veterans, with particular attention paid to those at greater risk due to social determinants of health 13.

EXECUTIVE SUMMARY - 5

Executive Summary KEY FINDINGS & RECOMMENDATIONS 15.

The VA should establish a method for monitoring the effects of changes in purchased and referred care such as the Veterans Choice Program.

Areas of inquiry should include an analysis of whether or not administrative issues present a barrier to non-VHA providers who may otherwise be qualified or interested in serving veterans

Special considerations: Suicide findings

■ Veterans aged 18-34 are at the highest risk for suicide in Oregon and are more vulnerable the more recently they have been discharged from service

recommendations

OHA and ODVA should continue efforts to improve and coordinate suicide prevention programs specific to the veteran population pursuant to current strategic initiative articulated in: ■ VA’s National Strategy for Preventing Veteran Suicide ■ Oregon Public Health State Health Improvement Plan 17. Recognizing the critical role of innovation in problem solving and systems change, OHA, ODVA, and the VA Health Care Systems in Oregon are encouraged to seek out and embrace promising innovative practices. OHA and ODVA could, for example, collaborate to develop artist-in-residence programs with the intention of decreasing suicide risk by exploring creative solutions to welcome returning veterans home and assist their transition back into their communities 16.

Special considerations: Military sexual trauma findings

■ Veterans’ capacity for care-seeking is impacted by both a military culture of behavioral health stigma and the effects of trauma. In older female veterans especially, the effects of long-held trauma and related secrecy are compounded. Female veterans with military sexual trauma report discomfort or fear at VHA facilities, and providers report a need for more community-based, gender-specific care options ■ Both male and female veterans experience military sexual trauma, however, a high percentage (at least 50%) of female veterans in Oregon have experienced military sexual trauma. There are no inpatient military sexual trauma treatment programs within the state, and female veterans report in greater proportion than male veterans feeling that they have needed behavioral health services and did not receive them EXECUTIVE SUMMARY - 6

Executive Summary KEY FINDINGS & RECOMMENDATIONS recommendations

18.

OHA, ODVA, and VA Health Care Systems in Oregon should improve access to treatment for military sexual trauma by reconfiguring clinical spaces and intake processes, increasing the number of providers who are specially trained to identify and treat military sexual trauma, and conducting a cost analysis study for establishing an inpatient option in Oregon. Residential options must provide separate sleeping areas for men and women

Special considerations: Housing findings

Key informants from the VHA, CMHPs, and CCOs interviewed for this report identified housing insecurity and homelessness as a serious challenge in providing care to veterans â– The stability, quality, safety, and affordability of housing affects health outcomes at the individual and population levels â–

recommendations

19.

Like all social determinants of health, housing must be a consideration in efforts to improve behavioral health outcomes. ODVA, OHA, and the VA Health Care Systems in Oregon all support or provide resources and information for veterans experiencing homelessness; in addition, OHA should continue efforts (building on current work with CCOs) to prevent housing insecurity and homelessness, systemically

EXECUTIVE SUMMARY - 7